Kardiologie up2date 2011; 7(1): 15-21
DOI: 10.1055/s-0030-1256385
Hotline – Herzrhythmusstörungen

© Georg Thieme Verlag KG Stuttgart · New York

Update der ESC-Leitlinie zum Management des Vorhofflimmerns

Claus  Schmitt, Armin  Luik, Andrea  Radzewitz
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Publication Date:
04 April 2011 (online)


The 2010 Update of the European Society of Cardiology (ESC) guidelines for management of atrial fibrillation have been published. In this Hotline article a short summary is given of these new guidelines. They provide an effective tool for making evidence based decisions on therapy. The guidelines contain a number of new elements. A new type of atrial fibrillation named long-persisting atrial fibrillation has been identified. The guidelines contain recommendations on the use of antithrombotic therapy and heart rate control. A strict antithrombotic therapy with vitamin K antagonist is advised. The guidelines include a series of new scores as the extension of the CHADS2 via the CHA2DS2-VASc-Score for the estimation of thromboembolic risk. There is a further update on the new EHRA Score for the classification of the symptoms of the patients during atrial fibrillation and the HAS-Bled Score assessing the bleeding risk. Based on the results of the RACE II trial the rate control can be adjusted. The trial has shown that in the patients enrolled in RACE II a lenient rate control therapy is reasonable compared to strict rate control under 80 beats per minute. Dronedarone was established in the guidelines as first line therapy. Catheter ablation can be considered as an initial therapy in symptomatic patients with paroxysmal AF and minimal or no heart disease (hypertension and no left-ventricular hypertrophy).


Prof. Dr. med. Claus Schmitt

Städtisches Klinikum Karlsruhe
Medizinische Klinik IV

Moltkestr. 90
76133 Karlsruhe

Email: [email protected]